Form - Letter - ESA Pet Support

Emotional Support and Psychiatric Service Animal Letter Questionnaire

This is ESA questionnaire is the first step in receiving a legitimate Emotional Support Animal Letter and or a Psychiatric Service Dog Letter!. All you need is the letter nothing more. There are no governmental registration recognized entity to register your animal. The only thing you need is the letter. Once I receive the results I will contact you via email or phone on the next steps. Please feel free to look up my BIO to find out more about me at https://ercounselingandconsulting.com/about/ .

If you are having suicidal thoughts and need to talk to a crisis counselor you have several options. Please call the National Suicide Prevention Lifeline 1-800-273-8255 (TALK)
Crisis Textline: Text “HOME” to 741-741

Your Email

How many pets are you needing an emotional support animal letter for ? ( please be aware there is additional fees per pet)

Are you over 18 years old?

Please provide your full legal name

Phone

How soon do you need the letter or prescription for ESA?

Does your animal provide you with comfort when you are experiencing stress, anxiety or feelings of depression?

Have you been previously diagnosed or believe you have a mental disability like anxiety, depression, PTSD?

Have you experienced consistent feelings of hopelessness or depression within the last 3-6 months?

Do you find yourself unable to relax?

Do you have fears of catostrophic accident may happen?

Do you experience restlessness or on edge?

Have you experienced panic attacks while outside your home or in a public setting?

Do you experience feelings of nervousness?

Over the past two months, have you felt more angry or more irritated than usual?

Over the past two months, how often have you been acting impulsively?

Do you experience feelings of sadness?

Do you find yourself with low energy even though you are sleeping over 8 hours a night?

Have you experienced difficulty sleeping?

Do you experience mood swings or irritability?

Are you currently taking any medications for mental health?

Over the past two (2) weeks, have you felt you had little interest or pleasure in doing things that you usually like to do?

Have you experienced significant weight changes?

Are you currently a pet owner?

Are you living in a apartment or house and pay a pet fee?

Are you currently living in or planning to live in an apartment or house where they do not allow pets?

What state do you currently reside in?

Is your emotional support animal recommendation time sensitive?

What type of pet are you looking to make an emotional support animal?

What type of breed is your animal and how much does it weigh? ( some residential areas have weight limits)

What is the complete address your emotional support animal will be living? If you have not relocated to the area please provide current address.

Once you've completed the complimentary assessment and are approved, are you prepared to proceed with the $99 letter fee?

Yes